code 99024 once for each postoperative visit. Furthermore, the proposed rule would have required reporting
on all 10- and 90-day global codes, rather than the
narrow list of high-volume and high-Medicare expenditure codes. Finally, the proposed rule would have
required reporting to begin January 1, rather than July
1, as finalized. (See Table 1, this page, for revisions to
the proposed rule advocated by the ACS.)

ACS legislative and regulatory advocacy efforts
included letters to lawmakers on Capitol Hill and
to CMS staff, in-person meetings with members of
Congress, participation in CMS town hall meetings,
strategic meetings of the ACS Health Policy and
Advocacy Group and General Surgery Coding and
Reimbursement Committee, and the formation of an
ACS-led Globals Coalition made up of multiple medical associations.

Improving payment accuracy forcare of people with disabilities

In the 2017 MPFS proposed rule, CMS proposed the
creation of a new add-on code (G0501) to describe additional services furnished in conjunction with evaluation
and management (E/M) services to beneficiaries with
disabilities that impair their mobility. CMS indicated
that the proposed add-on code would be reported with
physician office and outpatient E/M codes (99201–99205,
99212–99215), as well as transitional care management
codes (99495, 99496).

In their comments on the proposed rule, the ACSand other medical specialty associations agreed withCMS’ statement of disability disparities and perspectiveon the challenges that individuals with disabilities facein accessing the health care system. However, most alsoagreed that the root cause and scope of these issues arenot well defined and suggested that CMS work withstakeholders to conduct additional studies and gaininformation regarding the underlying reasons for barri-ers to access to care and lower quality scores on certainmeasures.

CMS did not finalize payment for code G0501 and
instead indicated the agency will engage with interested beneficiaries, advocates, and practitioners to
continue to explore improvements in payment accuracy for care of people with disabilities. In addition, the
agency included the code G0501 in the HCPCS code
set and noted that practitioners would be able to report
the code if they were so inclined.

Non-face-to-face prolonged E/M services

Public commenters have repeatedly recommended that
CMS establish separate payments for many services
that are currently bundled under the MPFS, including
non-face-to-face prolonged E/M service codes: 99358,
Prolonged evaluation and management service before
and/or after direct patient care; first hour, and 99359,
Prolonged evaluation and management service before
and/or after direct patient care; each additional 30 minutes (List separately in addition to code for prolonged
service). These non-face-to-face prolonged service codes
are broadly described (although they include only
time personally spent by the physician or other billing

2017 MEDICARE PHYSICIAN FEE SCHEDULE

TABLE 1.

SUMMARY OF PROPOSED AND FINAL REQUIREMENTS FOR REPORTING GLOBAL SERVICES

PROVISION PROPOSED FINAL
Start date January 1 July 1

How dataare reportedG-codes reported in 10-minuteincrements Use 99024 to report number of postoperative visitsWhat dataare reportedPre-service and postoperativecare on all 10- and 90-dayglobal codesJust postoperative visits on only high-volume or high-expenditure 10- and 90-day global codesWho reportsthe dataAll physicians, regardless ofpractice size, who provide 10-and 90-day services in all statesPhysicians who provide 10- and 90-day services who are:•In a practice of 10 or more practitioners•In one of the identified nine states (Florida, Kentucky, Louisiana,Nevada, New Jersey, North Dakota, Ohio, Oregon, and Rhode Island),comprising a representative sample, which was required by MACRA